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Non-Surgical Treatment for Atrial Septal Defect – Transcatheter ASD Closure

Atrial Septal Defect (ASD) is a congenital heart defect that occurs in children or teenagers. However, some are diagnosed in their adulthood.

Dr. Suphasit Sathittrakool, a cardiologist at Vejthani Hospital, explained that atrial septal defect (ASD) is a congenital heart defect that occurs with abnormal heart development in the womb, causing a leak in the wall that separates the upper chambers of the heart, the atria. This opening allows oxygen-rich blood from the left atrium to mix with oxygen-poor blood from the right atrium, causing extra blood to flow to the lungs. This results in an abnormal enlargement of the heart. If left untreated for a long time, it will lead to pulmonary hypertension and, eventually, heart failure.

The symptoms of atrial septal defect vary on the size and location of the defect. In general, children with significant defects are more likely to experience symptoms in the early stage. They could have rapid breathing, fatigue easily, less milk consumption, slow weight gain, excessive sweating, frequent lung infections, and bluish skin tone (cyanosis). Patients with minor defects may not experience any symptoms during childhood and adolescence. As they enter adulthood, they may begin to experience signs like fatigue, shortness of breath, especially during exertion, heart palpitations, decreased exercise tolerance, and dizziness or fainting. However, in some cases, this condition may be detected during annual routine checkups without noticeable symptoms.

Diagnosis of atrial septal defect (ASD) typically begins with a medical history, physical examination, and the checking of heartbeat. Other procedures include an electrocardiogram (ECG), chest X-ray, and echocardiogram. An echocardiogram provides a detailed view of the heart’s internal structures, including the atrial septum, heart muscle, and heart valves. If a defect is found, the doctor can assess its size, location, blood flow direction, and pulmonary pressure to plan a proper treatment.

Treatment for ASD depends on the size, location, and severity of the defect, as well as the patient’s age and overall health. The options include:

For pediatric patients with tiny atrial septal defect (ASD), no complications, and no symptoms or impact on daily life, ASD closure may not be immediately necessary. However, ongoing monitoring is crucial.
Medications are used to control the symptoms of heart failure and heart arrhythmia, but they cannot close the defect.
A surgical method is a traditional approach considered for patients with large defects, multiple defects, or defects in locations that cannot be treated with non-surgical methods like catheterization.
Transcatheter ASD Closure is an alternative treatment option for atrial septal defect (ASD), but it is suitable for certain kinds of defect, which the doctor will decide. Transcatheter ASD Closure is a minimally invasive procedure that involves inserting a catheter with a metal device through the vein in the groin that leads to the heart. The device is then used to close the atrial septal defect. The body then gradually forms tissue over it within 3-6 months. The procedure takes approximately 1-2 hours and offers several advantages over open-heart surgery, including reduced pain, fewer complications, smaller incisions, and faster recovery.

Post-Procedural Care at Home after Transcatheter ASD Closure

Take antiplatelet medication as prescribed by your doctor, and complete the full course as per the doctor’s recommendation. If stopping the medication is required, contact your doctor before doing so.
Avoid walking too often in the first 1-2 days, and keep the wound dry. Observe the wound for any abnormalities, such as redness, swelling, lumps under the skin that are painful when touched, pus or drainage, or fever. If any of these signs appear, seek immediate medical attention.
The doctor will schedule follow-up appointments at one month, three months, six months, and one year to monitor your condition. Attend all the scheduled appointments promptly.
Maintain good oral hygiene to prevent tooth decay. If tooth decay occurs, consult a dentist in time before undergoing any treatment. Antibiotics may be prescribed at the doctor’s discretion to avoid complications, including infective endocarditis.
Avoid lifting heavy objects for approximately one month. Refrain from strenuous exercise for the first three months.

Patients of reproductive age can resume sexual intercourse 1-2 weeks after atrial septal defect (ASD) closure. However, it is advised to consult with your doctor to ensure safety.